Individual provider Active NPI

Diane Light, MD

  • Obstetrics & Gynecology Physician
  • Castle Rock, CO
National Provider Identifier
1346879814
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DR.0073212 Issued in CO
Practice address
2356 Meadows Blvd Ste 240B
Castle Rock, CO 80109-8410
Phone
(303) 649-3380
Fax
(303) 649-3381
NPI assigned
Apr 6, 2020
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X DR.0073212 CO Primary

Addresses

Primary practice location

2356 Meadows Blvd Ste 240B
Castle Rock, CO 80109-8410

Mailing address

4001 N 3Rd St Ste 290
Phoenix, AZ 85012-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022005438 CO Practitioner - Obstetrics/Gynecology 3173056686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2350 Meadows Blvd
Castle Rock, CO 80109-8405
Phone (720) 455-0650

2353 Meadows Blvd
Suite 300
Castle Rock, CO 80109-8405
Phone (720) 455-3750

2360 Meadows Blvd
Suite 300
Castle Rock, CO 80109-8405
Phone (303) 715-7106

2535 S Downing St
Denver, CO 80210-5850
Phone (303) 778-5797

9695 S Yosemite St
Lone Tree, CO 80124-2890

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0073212COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Oct 7, 2024 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Oct 7, 2024 Accepting new patients
Portercare Adventist Health System Obstetrics & Gynecology Past Accepting new patients

Locations

2356 Meadows Blvd
Ste 240B
Castle Rock, CO 80109
Phone (303) 649-3380

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

Interoperability endpoints

  • Direct secure messaging: dlight4054666@adventhealth.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1346879814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 N 3RD ST STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 MEADOWS BLVD STE 240B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098410",
            "telephone_number": "303-649-3380",
            "fax_number": "303-649-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "DR.0073212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.